One of the most rapidly progressing areas in surgical treatment of patients is minimally invasive surgery, exemplified by laparoscopic surgery. Laparoscopic surgery, which is typically used for surgical treatment within the abdominal cavity, involves conducting the surgical procedure by use of one or more probes inserted through the abdominal wall. The probe(s) delivers the surgical capability into the abdominal cavity. Since only small incision(s) need to be made in the abdominal wall to insert the probe(s) and gain access to the interior organs and tissues, the procedure is regarded as minimally invasive.
To gain access to the abdominal cavity, the abdominal wall is typically penetrated with a device called a trocar. The trocar is attached to a cannula or sheath. After penetration the trocar is withdrawn through the cannula. The abdominal cavity is then pressurized by a flow of gas delivered from an inflation pump through the cannula, and the abdominal wall expands away from the internal organs and tissues. The expansion of the abdominal wall occurs slowly and carefully so as not to damage any of the interior organs or tissues. A pressure sensor on the inflation pump senses the back pressure from the abdominal cavity and terminates the delivery of gas once the pressure reaches an upper limit. The expansion of the abdominal wall provides good access to the interior organs.
After inflation, the probes and other surgical instruments are inserted into the abdominal cavity through a hollow interior of the cannula. A seal on the interior of the cannula contacts the probe to prevent the escape of gas from the abdominal cavity. The probes can then be manipulated from side to side due to the flexibility of the abdominal wall where the cannula penetrates it.
In typical surgeries, a combined light source and video camera device is inserted through one of the cannulas. The interior of the abdominal cavity is illuminated and the images received by the video camera are displayed on a video monitor which is visible to the surgeon. As a result of viewing the video monitor the surgeon is able to manipulate the probes to accomplish the desired surgical effect.
A variety of previous probes are available for use in minimally invasive surgery. However, most of these prior probes are capable of only a single use or type of functionality, for example, standard electrosurgical cutting or coagulation. A few prior art probes may be capable of limited multiple functions, such as standard electrosurgical cutting and coagulation as well as mechanical cutting or biopsy collection.
Typically, however, previous probes simply provide a surgical effector function, e.g. cutting, coagulation, biopsy, etc., and do not facilitate the clearing of the surgical effector and/or the surgical site from fluids or debris.
Many methods of controlling intraoperative bleeding are available, including monopolar electrocautery, bipolar electrocautery, ultrasonic coagulation, and electrothermal bipolar vessel sealing. While reasonable in their efficacy, each has limitations and disadvantages. More importantly, the area must be visualized prior to use of the device using either irrigation and suction or a gauze sponge.